Abstract
Objective To systematically review the efficacy and safety of postoperative radiotherapy and postoperative chemotherapy for patients with endometrial cancer, which may give support for clinical proper selection. Methods The randomized controlled trials (RCTs) comparing postoperative radiotherapy with postoperative chemotherapy for patients with endometrial cancer were searched in EMBase, PubMed, Cochrane Library, Chinese Biomedical Literature Data, China National Knowledge Infrastructure, and VIP database from the inception to August 2015. Two reviewers independently assessed the quality of included studies and extracted data. We analyzed the statistic data using RevMan 5.1 software. Results Three RCTs concluding 1 121 patients were included. Meta analysis showed that there were no significant differences between the two groups in five-year survival rate (RR=0.94, 95%CI: 0.80-1.10, Z=0.77, P=0.440), five-year progression-free survival rate (RR=0.98, 95%CI: 0.90-1.07, Z=0.52, P=0.610) and recurrence rate (RR=1.06, 95%CI: 0.91-1.24, Z=0.75, P=0.450), but there were significant differences between the two groups in grade 3-4 thrombocytopenia (RR=0.13, 95%CI: 0.07-0.27, Z=5.62, P<0.000 01) and grade 3-4 neutropenia (RR=0.01, 95%CI: 0.00-0.03, Z=8.27, P<0.000 01). Subgroup analysis showed that there were significant differences between the two groups in five-year survival rate (RR=0.79, 95%CI: 0.68-0.91, Z=3.15, P=0.002) and five-year progression-free survival rate (RR=0.82, 95%CI: 0.69-0.97, Z=2.31, P=0.020) for patients with Ⅲ-Ⅳ stage endometrial cancer. Conclusion Current evidence indicates that compared with postoperative radiotherapy, postoperative chemotherapy may improve the survival rate for patients with advanced stage endometrial cancer. The long-term curative effects still need to be confirmed by RCTs with high quality and large sample. Key words: Radiotherapy; Drug therapy; Endometrial neoplasms; Meta-analysis
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